PCOS, endometriosis & your mental health
These conditions touch your body, your mood and how you see yourself. Your feelings make sense, and you deserve care for all of it.
By the numbers
How common these conditions are, and how they affect mood.
PMOS (PCOS)
Endometriosis
Two common conditions, in plain words
What PMOS and endometriosis are, and why they affect more than your body.
PMOS and endometriosis are two of the most common conditions affecting people with periods. They are very different, but both can bring pain, body changes, fertility worries and years of searching for answers.
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Polycystic ovary syndrome was renamed polyendocrine metabolic ovarian syndrome (PMOS) in 2026, after a global consensus published in The Lancet. The new name shows that it affects hormones and metabolism across the body, not just the ovaries. Many people and doctors will still say PCOS for a while.
Common signs include irregular or absent periods, extra hair on the face or body, hair thinning, acne and trouble getting pregnant. The cause is unknown, but a family history of PCOS or type 2 diabetes raises the risk.
It can also raise the risk of some long-term conditions, like type 2 diabetes and high blood pressure. Regular checkups help.
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Endometriosis can cause severe period pain, heavy bleeding, pelvic pain that continues after your period, pain during sex, bloating, nausea and tiredness. It can also affect bowel movements and peeing. Some people have no symptoms.
It is especially common in women in their 30s and 40s. It can also affect trans men and nonbinary people who have periods.
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The NHS lists depression and anxiety among the main symptoms of PMOS. The WHO says endometriosis can cause depression and anxiety, and that stigma and the downplaying of period pain make it worse.
The link with anxiety and low mood
Why mood struggles are so common, and why experts say to check.
A review of studies found women with PCOS had about four times the odds of depressive symptoms and more than five times the odds of anxiety symptoms. The link held even when body weight was taken into account.
The international PCOS guideline says depression should be screened for in all adults and teens with PCOS, and anxiety in all adults. This means it is normal and expected for your provider to ask about your mood.
In endometriosis, a 2023 review found depression and anxiety were linked with the condition, and pain was strongly linked with both. Tiredness and poor sleep were linked with lower mood too. The authors call for routine checks on emotional wellbeing.
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- Body changes that affect self-image
- Fertility worries
- Living with pain day after day
- Poor sleep and tiredness
- Stigma and not being believed
- Years without a clear diagnosis
Researchers are still learning how much comes from the conditions themselves and how much from living with them. Either way, the feelings are real and deserve care.
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The guideline encourages providers to ask how the condition affects your quality of life and what your priorities are. You can bring it up first.
Words you could use
- “My mood has been really low since…”
- “I worry about this all the time.”
- “Can we talk about how this affects my mental health?”
Body image, hair, skin and weight stigma
When your body changes in ways you didn’t choose.
The international guideline recognises that features of PCOS can have a negative impact on body image. Extra hair, hair thinning, acne and weight changes can affect how you feel in your skin.
The WHO notes that unwanted hair growth, weight and infertility are subject to social stigma in many places. That stigma can affect relationships, work and mental health.
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The guideline says many women with PCOS experience weight stigma in health care and other settings. It asks clinicians to recognise their own biases and notes that words like “obese” can feel stigmatising.
The WHO says healthy habits matter for everyone with PCOS, even when they do not lead to weight loss. Your health is about more than a number.
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- Curate your feed: unfollow accounts that make you feel worse
- Notice what your body does for you, not just how it looks
- Speak to yourself as you would to a friend
- Wear what feels comfortable
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PMOS often starts around puberty, when fitting in can feel so important. The guideline recommends screening for depression in teens with PCOS too.
If you are a parent, focus on how your teen feels rather than how they look. Listening without fixing goes a long way.
Food, eating and PMOS
When advice about food turns into worry about food.
People with PMOS often hear a lot about food and weight. The international guideline says eating disorders and disordered eating should be considered in PCOS, regardless of weight.
The WHO also lists eating disorders among the conditions women with PCOS may experience. Strict rules, guilt after eating, or cycles of restricting and bingeing are worth talking about.
Signs food may be taking over
- Feeling anxious or guilty about eating most days
- Skipping meals, then eating a lot in one go
- Food rules that keep getting stricter
- Thinking about food or your body much of the day
Living with endometriosis pain
How pain affects mood, work and daily life, and what can help.
Severe pain, heavy bleeding, tiredness and isolation can dramatically reduce quality of life. Some people cannot go to work or school on bad days, which can bring money worries too.
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The WHO says physiotherapy and cognitive behavioural therapy (CBT), as part of a team approach to pain, can reduce pain and improve quality of life. Pelvic floor muscles can also play a part in ongoing pelvic pain.
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- Break big tasks into smaller pieces
- Keep a pain and period diary to spot patterns
- Plan rest before and after busy days
- Use heat and gentle movement if they help you
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The WHO notes that endometriosis can mean lost days at work or school and lost income. You can talk with your employer, HR or school about flexible hours, working from home or rest breaks.
Sex, intimacy and relationships
When pain or self-image gets in the way of closeness.
Pain during or after sex is a common symptom of endometriosis. It is often felt as a deep pain. Some people start avoiding sex, which can affect both partners.
With PCOS, the guideline notes that body image, hair growth and mood can all affect sexual wellbeing. It says providers should ask permission before discussing it, so you stay in control of the conversation.
Things that can help
- Find other ways to be close: touch, time together, talking
- Plan intimacy for days when pain is usually lower
- Talk with your partner outside the bedroom
- Tell your provider if sex hurts: it is a real symptom
Fertility worries
Living with uncertainty about having children.
Both conditions can make it harder to get pregnant. Researchers think endometriosis may affect as many as 1 in 2 women with infertility, though many women with endometriosis do get pregnant.
Most women with PCOS find out in their 20s or 30s, often when trying to get pregnant. Infertility was one of the top concerns for women in a large PCOS survey.
Worry about the future can be heavy even if you are not trying for a baby now. In endometriosis, research suggests that infertility together with childlessness may weigh most on mental health.
The long road to a diagnosis
Years of “it’s normal” can leave scars.
In a survey of 1,385 women with PCOS, a third waited more than two years and almost half saw three or more health professionals before being diagnosed. Only about 1 in 3 were satisfied with how they were diagnosed.
For endometriosis, the average time to diagnosis is 4 to 12 years. In a review, longer delays were linked with lower quality of life.
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Finally having a name can bring relief: “I wasn’t making it up.” It can also bring grief or anger about the years lost.
All of these feelings are valid. Talking them through with someone you trust, or a therapist, can help you make peace with the past.
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Satisfaction with information was strongly linked to satisfaction with diagnosis. The guideline calls information a high priority and warns about misinformation online.
How community and loved ones help
Belief, practical help and people who understand.
Patient support groups offer advice and emotional support. Talking with others who have the same condition can ease isolation and help you feel understood.
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- Ask what a bad day looks like and how you can help
- Avoid comments about weight, hair or skin
- Don’t say “periods hurt for everyone”
- Help with chores on high-pain days
- Offer to come to appointments
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Look for groups run by condition charities, local hospitals or women’s health clinics. Online communities can help if you live far from others or have bad days.
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The WHO says many people, including health workers, still don’t know that ongoing pelvic pain is not normal. Awareness helps others get diagnosed sooner.
You never have to share more than feels right. Your story is yours.
When and where to get help
Signs it’s time to reach out, and where to go.
Reach out if…
- Low mood or worry lasts more than two weeks
- Food, eating or your body is on your mind most of the day
- Pain stops you from working, studying or sleeping
- You feel hopeless or have thoughts of harming yourself
Good places to start are your primary care provider, gynaecologist or a women’s health clinic. Talking therapy, online or in person, can help with the emotional side.
Outside the U.S.: Find A Helpline (findahelpline.com) lists free, confidential helplines in many countries. In an emergency, call your local emergency number.
📝 Worksheets for this guide
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Sources
- World Health Organization (WHO). Polycystic ovary syndrome fact sheet
- World Health Organization (WHO). Endometriosis fact sheet
- Teede H. et al. (peer-reviewed) (2026). Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process (The Lancet)
- NHS (UK National Health Service). Polyendocrine metabolic ovarian syndrome (PMOS), formerly PCOS
- NHS (UK National Health Service). Endometriosis
- Office on Women’s Health (womenshealth.gov). Endometriosis
- Office on Women’s Health (womenshealth.gov). Polycystic ovary syndrome
- Cooney L.G., Lee I., Sammel M.D. & Dokras A. (peer-reviewed) (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis (Human Reproduction 32(5): 1075–1091)
- Teede H.J. et al. (peer-reviewed) (2023). Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (Journal of Clinical Endocrinology & Metabolism 108(10): 2447–2469)
- Szypłowska M., Tarkowski R. & Kułak K. (peer-reviewed) (2023). The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review (Frontiers in Public Health 11: 1230303)
- Gibson-Helm M. et al. (peer-reviewed) (2017). Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (Journal of Clinical Endocrinology & Metabolism 102(2): 604–612)
- National Institute of Mental Health (NIMH). Depression in Women: 4 Things to Know
- Find A Helpline (ThroughLine). Find A Helpline
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
